Across the Table McGuireWoods - Alyssa Campbell and Kayla McCann Marty

In this special crossover edition of Across the Table, we're excited to republish an insightful episode from our sister podcast, Deal-by-Deal. Host Greg Hawver talks to fellow McGuireWoods partner Holden Brooks about antitrust considerations for private equity investors in the middle market (and, interestingly, the lower middle market).
They begin by discussing the Hart-Scott-Rodino Act, which requires pre-close filings for deals valued above $111.4 million that also meet certain other criteria — and note that some add-on strategies and other deals below this threshold may be subject to investigation by the Federal Trade Commission or Department of Justice if there are antitrust concerns.
Hawver and Brooks also discuss FTC v. U.S. Anesthesia Partners and Welsh Carson, a lawsuit that highlights the importance of assessing one's own acquisition conduct, being precise and accurate in communications and documents, and involving antitrust counsel in the pipeline stage of deals.
Join us as we bridge the gap between Across The Table and Deal-by-Deal, bringing you the best of both worlds under the roof of McGuireWoods.
Meet Your Guest Name: Holden Brooks
Title: Partner, McGuireWoods
Speciality: Holden is a partner in the firm’s Antitrust, Trade and Commercial Litigation Department, where her practice focuses on mergers, complex litigation, civil and criminal enforcement, and counseling across several industries with significant experience in the area of healthcare.
Connect: LinkedIn 
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This podcast was recorded and is being made available by McGuireWoods for informational purposes only. By accessing this podcast, you acknowledge that McGuireWoods makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in the podcast. The views, information, or opinions expressed during this podcast series are solely those of the individuals involved and do not necessarily reflect those of McGuireWoods. This podcast should not be used as a substitute for competent legal advice from a licensed professional attorney in your state and should not be construed as an offer to make or consider any investment or course of action.

On this episode of Across the Table, host Kayla McCann Marty is joined by Alexis Rathborne, Managing Director of Investments at Trident for a discussion on the healthcare market and the investment thesis driving Trident’s team. Alexis explains how she applies Trident’s investment thesis – that identifying the right investment and operating partners is key to successful acquisitions – to the specialized physician investments she reviews.   For Alexis, the right deal is all about finding the right asset within those specialties and the right partners to work in those sub-industries.
This approach reflects Trident’s belief that their operating partners–including CEOs, physician partners, and others on the ground–are just as important in driving their success as anything else, and they have no problem sharing credit with them.
Throughout the episode, Alexis shares insights into popular sub-sectors of healthcare investing that have interested the Trident team, along with some of the current challenges involved in making an acquisitions deal. She and Kayla also share the opportunities they see in the market and what they anticipate looking ahead. 
 
Featured GuestName: Alexis Rathborne
What she does: Alexis Rathborne is a Managing Director of Investments at Trident. Since joining Trident in 2019, she has been instrumental in executing Trident’s investment thesis. Prior to Trident, Alexis led direct investing at Clear River, a single-family office in New York City, with a focus on restaurant investments.
Organization: Trident
Connect: LinkedIn 

Acquired KnowledgeTop takeaways from this Across the Table episode 
Having the right asset and partner makes an investment interesting. According to Alexis, Trident is interested in the optometry space due to the level of unconsolidated practices and the quick synergies that can be exercised in the industry. Independent sponsors bring unique strengths. Working with operating partners or independent sponsors can help you find unique investment opportunities that are off the beaten path and not banked. Valuations have been challenging in healthcare. With tightening debt markets requiring either lower valuations or larger equity investments, valuing acquisitions has been challenging. COVID has also affected practices differently, and there has been a disconnect between valuations and intrinsic value.

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This podcast was recorded and is being made available by McGuireWoods for informational purposes only. By accessing this podcast, you acknowledge that McGuireWoods makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in the podcast. The views, information, or opinions expressed during this podcast series are solely those of the...

When leading a company, few things are as important as building a strong team and empowering those team members, according to Matthew Pettit, founding partner of Seven Hills Capital.
Before Matt formed Seven Hills Capital, he founded and worked as CEO of another successful business, Ascend Dermatology. His goal was to create an organization that provided top-tier compassionate care to dermatology patients and to offer a unique succession planning vehicle for practice owners. With that expertise under his belt and his prior experience as a healthcare private equity investor, Matt took his skill set and started Seven Hills Capital, an operator centric private equity firm focused on the healthcare industry.
On this episode of Across the Table, host Alyssa Campbell speaks with Matt about successful strategies he and his team have used to address staffing challenges, how acquisition growth strategies have shifted in a post-COVID world, and his emphasis on positivity in the workplace.
Featured GuestName: Matthew Pettit
What he does: As the founder of Seven Hills Capital, Matthew is focused on building the best in class healthcare services companies. Matthew set out to create a long-term operating perspective to healthcare services investing.
Organization: Seven Hills Capital
Connect: LinkedIn
Acquired KnowledgeTop takeaways from this Across the Table episode 
The key to retaining employees comes down to good recruitment and good treatment. Matthew credits Seven Hills Capital’s partner companies' skilled recruiters with creating positive work cultures and articulating the company’s goals to prospective employees. Their partner companies provide health benefits and compensations competitive with larger companies, and for back-of-house employees, it also provides in-house daycare and hybrid work-from-home options.Sometimes, you need to take conversations to the front end. When approaching the close of an acquisition process, it’s important to talk to the actual providers. Matthew attributes this to the large spread between buyers and sellers, as well as a tightening market in which cash flow becomes more important.A company is only as good as its employees. Matthew operates under the notion that the right partners will positively impact, change, and drive culture. He believes if you empower employees to grow the way they want, the practice will thrive.
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This podcast was recorded and is being made available by McGuireWoods for informational purposes only. By accessing this podcast,...

On this episode of Across The Table, McGuireWoods partner Alyssa Campbell is joined by Colin McDermott and Savanna Ganyard of VMG health for a discussion of the publicly traded healthcare operator’s Q1 earnings reports, along with expectations for the rest of 2023. They also touch on whether today’s investment climate reflects a return to typical healthcare acquisition trends or if we’re entering a new post-pandemic era.
Public sector earning reports didn’t indicate any new trends across the industry as a whole for Q1, most of the notable trends were sector or company specific. 
According to Savanna, the valuations during this earnings season have been interesting. Colin echoes these observations, noting that, “as we see multiples trend down in the public sector, even slightly, that's going to compress what their [buyers] are willing to pay for private companies.”
VMG Health regularly follows 23 publicly traded healthcare operators so they can provide their clients with industry expertise. Each quarter they produce a one-page earnings summary with quotes on major themes. This information was made publicly available to all clients last year due to high interest, especially following COVID. The summaries can be found here.
 
Featured GuestsName: Savanna Ganyard
Organization: VGM Health
Connect: LinkedIn
Name: Colin McDermott
Organization: VGM Health
Connect: LinkedIn
Acquired KnowledgeTop takeaways from this Across the Table episode 
Q1 earnings reports varied by company and by sector. Of the healthcare companies VMG follows, 15 had positive revenue surprises and 12 had positive EBITDA surprises this quarter, with no major industry-wide trends. Valuation multiples remained flat or decreased slightly, and EBITDA decreased for half of the companies, indicating more sector or company-specific than industry-specific trends.This earning season has driven an interesting commentary on valuations. Companies that VMG is following have indicated they may be focused on targeting smaller companies and smaller deals compared to past years. Buyers are resetting purchase prices more quickly than sellers. This may result in an unwillingness to sell, or broken deals when prices must be reset. Private transaction pricing changes tend to be reflected more slowly, causing tension between buyers cautious with their investments and sellers who want to stick to their pricing.
 
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Honesty and trust are two of the most important elements of any strong relationship. The same is true for the business relationship between private practice physicians and investors, according to Andrea Balogh who joins host Kayla McCann Marty for this episode of Across The Table.
Andrea is the Chief Growth Officer and Chief Legal Officer at Integrated Oncology Network (ION), where she’s responsible for developing and executing the company’s growth strategy. She also spearheads ION’s business development, market strategies, and marketing and payer strategies teams. 
With more than a decade of experience in the healthcare private equity industry, Andrea believes three behaviors are essential to successful partnerships: open conversation, physicians and payers staying in (and respecting) each others’ lanes, and the alignment of goals and practices.
Tune in to the episode to learn how to develop strong partnerships and how investors can optimize their business relations and track trends in healthcare. 
Featured GuestName: Andrea Balogh
What she does: As the Chief Growth Officer and Chief Legal Officer at Integrated Oncology Network, Andrea is responsible for creating and executing ION's growth strategy across the United States, as well as leading their business development, market strategies, and marketing and payer strategies teams. 
Organization: Integrated Oncology Network
Connect: LinkedIn
Acquired KnowledgeTop takeaways from this Across the Table episode 
There are three ingredients to a successful acquisition. At ION, Andrea emphasizes the value in physicians having a close, community-based environment where they can deliver care at the right time and place. Honesty is the best policy. There is no better business practice than honest, open communication. The future of the private healthcare equity industry is shifting. Take note of the move toward comprehensive care in the independent practice setting and how it is shifting to larger scale practices and partnerships.

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Subscribe to Across the Table in your preferred podcast app so that you never miss an episode. 
This podcast was recorded and is being made available by McGuireWoods for informational purposes only. By accessing this podcast, you acknowledge that McGuireWoods makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in the podcast. The views, information, or opinions expressed during this podcast series are solely those of the individuals involved and do not necessarily reflect those of McGuireWoods. This podcast should not be used as a substitute for competent legal advice from a licensed professional attorney in your state and should not be construed as an offer to make or consider any investment or course of action.

In a “post-COVID” world, specialty care centers are trying to keep up with the ever-changing landscape of the healthcare market. 
On this episode of Across the Table, host Kayla McCann Marty talks with Kyle Lynch, a Group Vice President of Development at SCA Health, which is part of OptumCare and is a leader in specialty care, practice management solutions, and outpatient management. Through his work at SCA Health, Kyle leads the acquisition and new partnership activity in the physician practice and practice management space. 
Kyle discusses the company’s trend tracking, following how the market has changed since the beginning of COVID-19 and its prioritization of forming genuine partnerships that have longevity beyond the first five years. 
Tune in to learn about trends in the current market, how SCA Health tackles MSOs, and the hopeful turn toward a more care-centric model in specialty health.
Featured ExpertName: Kyle Lynch
What he does: As the Group Vice President of Development at SCA Health, Kyle Lynch leads the acquisition and new partnership activity in the specialist physician practice and practice management space.
Organization: SCA Health
Words of wisdom: “We [at SCA Health] are much more oriented around creating genuine partnerships where we can support practice operations and deliver our unique strategic value while preserving true physician practice autonomy.”
Connect: LinkedIn
Acquired KnowledgeTop takeaways from this Across the Table episode 
Genuine partnership is a must. Kyle and the team at SCA Health is focused on creating genuine partnerships in which they can provide their unique strategic planning while preserving the practice’s operations and autonomy. There’s a different way to think about MSOs. At SCA Health, MSOs are unrestricted. The MSO equity is almost immediately returned as a stream of constant income for shareholders.There is so much value in specialty practice spaces. Kyle explains the flow of value that can be utilized and monetized for the benefit of independent specialists. He believes SCA is perfectly positioned to capitalize on that for the sake of its clients.
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Subscribe to Across the Table in your preferred podcast app so that you never miss an episode. 
This podcast was recorded and is being made available by McGuireWoods for informational purposes only. By accessing this podcast, you acknowledge that McGuireWoods makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in the podcast. The views, information, or opinions expressed during this podcast series are solely those of the individuals involved and do not necessarily reflect those of McGuireWoods. This podcast should not be used as a substitute for competent legal advice from a licensed professional attorney in your state and should not be construed as an offer to make or consider any investment or course of action.